Category: ASC Coding, Billing and Collections

Anthem is the largest publicly traded Blue Cross Blue Shield affiliate, operating as a Blue Cross or Blue Cross Blue Shield plan in 14 states. 

Eighty-one percent of medical groups have seen an increase in prior authorization requirements since 2020, according to a poll conducted by the Medical Group Management Association in May.

An optometrist based in Carlisle, Mass., was indicted for billing fraud during the height of the pandemic.

Melbourne, Fla.-based Surgery Center of Viera filed a lawsuit Jan. 20 in Florida Middle District Court in Orlando against Cigna and Strategic Enterprise Solutions.

Both payers and CMS have noticed opportunities in value-based care to lower costs and strengthen patient care. 

Here are the major reimbursement updates since July 1: 

Value-based care and bundled payments have been gaining momentum in the ASC industry as a means to reduce healthcare costs and improve patient care. 

Surprise bills for colonoscopies following a stool-based screening test with positive results are now prohibited, according to Health Day. 

New York City-based insurance company Oscar Health introduced a price transparency tool that allows members to compare specific expenses for procedures at ASCs, hospitals and other settings.

Tri-State Specialists in Sioux City, Iowa, will pay hundreds of thousands of dollars to resolve billing fraud allegations.